Effects of low-dose nifedipine on urinary protein excretion rate in patients with renal disease

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
H J KlokeF T Huysmans

Abstract

The observation that proteinuria is an important determinant of the progression of renal disease has prompted numerous studies on the effects of antihypertensive agents on protein excretion. Reports on the proteinuric effects of calcium-channel blockers are quite controversial. It has been suggested that the short-acting dihydropyridine calcium-channel blocker nifedipine increases protein excretion by interference with tubular protein reabsorption. In a randomized controlled trial 10 patients with renal disease and proteinuria were treated with a dose of 10 mg nifedipine o.d. (slow release formulation) for 1 week. The acute effects on renal and systemic haemodynamics and on urinary albumin, IgG, and beta2-microglobulin excretion were investigated during a clearance study in the supine position after the first dose. After 1 week of treatment urinary protein excretion rates were measured in 24-h urine samples collected in the ambulatory patient in consecutive fractions of 4-8 h during normal daily activities. After the first dose nifedipine lowered mean arterial blood pressure in the supine position by 7+/-1 mmHg (<0.01), attenuated proximal tubular sodium reabsorption (fractional excretion of sodium 3.48+/-0.49 vs 2.62+/-0.35% d...Continue Reading

Citations

Dec 5, 1998·Kidney International. Supplement·D del CastilloR Pérez
Dec 26, 2001·Current Opinion in Nephrology and Hypertension·Giuseppe Remuzzi, Norberto Perico
Mar 15, 2008·Kidney International·P Hart, G L Bakris
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Apr 20, 2001·The Journal of Veterinary Medical Science·Y NakajimaS Kawamura
Jun 24, 1999·The Journal of Veterinary Medical Science·Y NakajimaS Kawamura

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